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Circulating Biomarkers Predict Symptomatic but Not Asymptomatic Carotid Artery Stenosis

Fatemi, Shahab LU ; Acosta, Stefan LU orcid ; Zarrouk, Moncef LU ; Engström, Gunnar LU ; Melander, Olle LU orcid and Gottsäter, Anders LU (2022) In Cerebrovascular Diseases 51(5). p.623-629
Abstract

Background: Subjects exposed to risk factors such as age, gender, hypertension, diabetes mellitus, and smoking are prone to atherosclerotic events. Aims: The main aim of this longitudinal cohort study was to determine whether the role of novel plasma biomarkers for atherosclerotic carotid artery disease is different in subjects developing symptomatic carotid artery stenosis (CAS), as opposed to those with incident asymptomatic CAS. Methods: The following biomarkers were measured in 5,550 middle-aged subjects in a population-based cohort study: C-reactive protein (CRP), lipoprotein-associated phospholipase A2 mass and activity, proneurotensin, midregional proadrenomedullin (MR-proADM), midregional proatrial natriuretic peptide... (More)

Background: Subjects exposed to risk factors such as age, gender, hypertension, diabetes mellitus, and smoking are prone to atherosclerotic events. Aims: The main aim of this longitudinal cohort study was to determine whether the role of novel plasma biomarkers for atherosclerotic carotid artery disease is different in subjects developing symptomatic carotid artery stenosis (CAS), as opposed to those with incident asymptomatic CAS. Methods: The following biomarkers were measured in 5,550 middle-aged subjects in a population-based cohort study: C-reactive protein (CRP), lipoprotein-associated phospholipase A2 mass and activity, proneurotensin, midregional proadrenomedullin (MR-proADM), midregional proatrial natriuretic peptide (MR-proANP), N-terminal pro-B-type natriuretic peptide (NT pro-BNP), copeptin, and cystatin C. After exclusion of those with prevalent CAS, subjects were thereafter followed in national patient registers for 23.4 (interquartile range 19.5-24.3) years regarding incident symptomatic and asymptomatic CAS. Results: Among 110 patients with confirmed incident CAS, 56 were symptomatic and 54 were asymptomatic. When including conventional risk markers in a Cox regression analysis, NT pro-BNP (hazard ratio [HR] 1.59; 95% confidence interval [CI]: 1.20-2.11), MR-proADM (HR 1.40; CI: 1.13-1.73), cystatin C (HR 1.21; CI: 1.02-1.43), and CRP (HR 1.53; CI: 1.13-1.73) were independently associated with incident symptomatic CAS, whereas no plasma biomarker was associated with incident asymptomatic CAS. Conclusion: Plasma biomarkers NT pro-BNP, MR-proADM, cystatin C, and CRP were independently associated with incident symptomatic CAS, whereas no such association could be demonstrated with incident asymptomatic CAS. As these biomarkers indicate future development of clinically relevant atherosclerotic CAS, their potential utility in relation to intensified preventive measures and selection of potential candidates for carotid surgery should be further evaluated.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Asymptomatic, Biomarkers, C-reactive protein, Carotid artery stenosis, Copeptin, Cystatin C, Lipoprotein-associated phospholipase A2, Midregional proadrenomedullin, Midregional proatrial natriuretic peptide, N-terminal pro-brain natriuretic peptide, Proneurotensin, Symptomatic
in
Cerebrovascular Diseases
volume
51
issue
5
pages
623 - 629
publisher
Karger
external identifiers
  • pmid:35340013
  • scopus:85128552284
ISSN
1015-9770
DOI
10.1159/000523839
language
English
LU publication?
yes
id
b069d0fe-3987-4f96-9586-4241f954a2a7
date added to LUP
2022-07-04 16:46:37
date last changed
2024-06-09 21:18:26
@article{b069d0fe-3987-4f96-9586-4241f954a2a7,
  abstract     = {{<p>Background: Subjects exposed to risk factors such as age, gender, hypertension, diabetes mellitus, and smoking are prone to atherosclerotic events. Aims: The main aim of this longitudinal cohort study was to determine whether the role of novel plasma biomarkers for atherosclerotic carotid artery disease is different in subjects developing symptomatic carotid artery stenosis (CAS), as opposed to those with incident asymptomatic CAS. Methods: The following biomarkers were measured in 5,550 middle-aged subjects in a population-based cohort study: C-reactive protein (CRP), lipoprotein-associated phospholipase A2 mass and activity, proneurotensin, midregional proadrenomedullin (MR-proADM), midregional proatrial natriuretic peptide (MR-proANP), N-terminal pro-B-type natriuretic peptide (NT pro-BNP), copeptin, and cystatin C. After exclusion of those with prevalent CAS, subjects were thereafter followed in national patient registers for 23.4 (interquartile range 19.5-24.3) years regarding incident symptomatic and asymptomatic CAS. Results: Among 110 patients with confirmed incident CAS, 56 were symptomatic and 54 were asymptomatic. When including conventional risk markers in a Cox regression analysis, NT pro-BNP (hazard ratio [HR] 1.59; 95% confidence interval [CI]: 1.20-2.11), MR-proADM (HR 1.40; CI: 1.13-1.73), cystatin C (HR 1.21; CI: 1.02-1.43), and CRP (HR 1.53; CI: 1.13-1.73) were independently associated with incident symptomatic CAS, whereas no plasma biomarker was associated with incident asymptomatic CAS. Conclusion: Plasma biomarkers NT pro-BNP, MR-proADM, cystatin C, and CRP were independently associated with incident symptomatic CAS, whereas no such association could be demonstrated with incident asymptomatic CAS. As these biomarkers indicate future development of clinically relevant atherosclerotic CAS, their potential utility in relation to intensified preventive measures and selection of potential candidates for carotid surgery should be further evaluated.</p>}},
  author       = {{Fatemi, Shahab and Acosta, Stefan and Zarrouk, Moncef and Engström, Gunnar and Melander, Olle and Gottsäter, Anders}},
  issn         = {{1015-9770}},
  keywords     = {{Asymptomatic; Biomarkers; C-reactive protein; Carotid artery stenosis; Copeptin; Cystatin C; Lipoprotein-associated phospholipase A2; Midregional proadrenomedullin; Midregional proatrial natriuretic peptide; N-terminal pro-brain natriuretic peptide; Proneurotensin; Symptomatic}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{623--629}},
  publisher    = {{Karger}},
  series       = {{Cerebrovascular Diseases}},
  title        = {{Circulating Biomarkers Predict Symptomatic but Not Asymptomatic Carotid Artery Stenosis}},
  url          = {{http://dx.doi.org/10.1159/000523839}},
  doi          = {{10.1159/000523839}},
  volume       = {{51}},
  year         = {{2022}},
}